Healthcare Provider Details

I. General information

NPI: 1316365976
Provider Name (Legal Business Name): GEOFFREY COLE CASAZZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HARVARD ST SE
MINNEAPOLIS MN
55455-0363
US

IV. Provider business mailing address

516 DELAWARE ST SE
MINNEAPOLIS MN
55455-0356
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-3000
  • Fax:
Mailing address:
  • Phone: 612-625-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number82960
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: